30B-011 (2) City of Northampton
s,
Massachusetts ��''
DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building
Northampton, MA 01060 �d
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Ui>� '+ INGLE OR TWO FAMILY SOLID FUEL APPLIANCE PERMIT APPLICATION
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OR WOOD, COAL, PELLET, CORN, STRAW OR SIMILAR STOVES, OR FIREPLACE INSERTS
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o Permit Fee: $25.00 Check # (�
PLEASE TYPE OR PRINT ALL INFORMATION
1. Name of Applicant:
Address: I�' Telephone: 1 j Q ' 2-5 r^
2. Owner of Property:
Address: / Telephone:
3. Status of Applicant: /Owner Contractor
,:
4. Type or Brand of Stove: 1 C
If applicant is not the homeowner:
Construction Supervisor's License Number Expiration Date
Home Improvement Contractor Registration Number Expiration Date
All Applicants must complete a Workers Compensation Insurance Affidavit before we can issue a permit
5. Certification: I hereby certify that the information contained herein is True and accurate to the best
of my knowledge. _ . '
DATE: �' ., APPLICANT'S SIGNATURE f
DATE: HOMEOWNER'S SIGNATURE
APPROVED
DATE: BUILDING OFFICIAL
41 LIBERTY ST BP-2015-0588
GIS#: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 30B-011 CITY OF NORTHAMPTON
Lot: -001 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: woodstove BUILDING PERMIT
Permit# BP-2015-0588
Project# JS-2015-001120
Est.Cost:
Fee: $25.00 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group: Homeowner as Contractor
Lot Size(sq. ft.): 10585.08 Owner: KRANTZ STEFANIE L
Zoning: URB(100)/ Applicant. KRANTZ STEFANIE L
AT: 41 LIBERTY ST
Applicant Address: Phone: Insurance:
41 LIBERTY ST
FLORENCEMA01062 ISSUED ON.1112012014 0:00:00
TO PERFORM THE FOLLOWING WORK.-INSTALL JOTUL 400 CASTINE WOODSTOVE
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy signature:
FeeType• Date Paid: Amount:
Building 11/20/2014 0:00:00 $25.00
212 Main Street, Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner